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Anatomical Variants of Post-ganglionic Fibers within the Pterygopalatine Fossa: Implications for Endonasal Skull Base Surgery

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机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA [3]Johns Hopkins Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA [4]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Neurol Surg, Columbus, OH 43210 USA
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关键词: vidian nerve pterygopalatine ganglion postganglionic fiber foramen lacerum orbit

摘要:
Objectives The vidian nerve provides parasympathetic innervation to the nasal cavity and the lacrimal gland. Previous anatomic studies have primarily focused on preservation or severance of the vidian nerve proximal to the pterygopalatine ganglion (PPG). This study aimed to assess its neural fibers within the pterygopalatine fossa after synapsing at the PPG, and to explore potential clinical implications for endoscopic endonasal skull base surgery. Methods An endonasal transpterygoid approach was performed on eight cadaveric specimens (16 sides). The PPG and maxillary nerve within the pterygopalatine fossa were divided. The vidian nerve was traced retrograde into the foramen lacerum, and postganglionic fibers distal to the PPG were dissected following the zygomatic nerve into the orbit. Potential communicating branches between the ophthalmic nerve (V1) and the PPG were also explored. Results All sides showed a plexus of neural communications between the PPG and the maxillary nerve. The zygomatic nerve exits the maxillary nerve close to the foramen rotundum, piercing the orbitalis muscle to enter the orbit in all sides. The zygomatic nerve was identified running beneath the inferior rectus muscle toward a lateral direction. In 7/16 sides (43.75%), a connecting branch between V (1) and the pterygopalatine ganglion was observed. Conclusion Neural communications between the PPG and the maxillary nerve were present in all specimens. A neural branch from V (1) to the PPG potentially contributes additional postganglionic parasympathetic function to the lacrimal gland.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2020]版:
Q3 SURGERY Q4 CLINICAL NEUROLOGY
最新[2023]版:
Q3 SURGERY Q4 CLINICAL NEUROLOGY

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA
通讯作者:
通讯机构: [2]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA [4]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Neurol Surg, Columbus, OH 43210 USA [*1]Ohio State Univ, Wexner Med Ctr, James Canc Ctr, Dept Otolaryngol Head & Neck Surg, Starling Loving Hall,Room B221,614-685-6778, Columbus, OH 43210 USA
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